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bowling mom
10-12-2009, 11:15 AM
We have switched to a new pro shop this year. The driller suggested a tighter thumb hole with 1/16 reverse pitch. Since then, my daughter has noticed a half-inch brown discoloration on the tip of the inside of her thumb. I have been trying to research if this is due to the reverse pitch, or if it's due to the snugness of the hole. The other kids from that pro shop have the same "burn mark" and they believe it's normal and nothing to worry about.

1. Is this normal?
2. What is this exactly? How is it caused, how can it be fixed?
3. What are the potential long-term effects, i.e. possible nerve damage?
4. Should this be changed?

I would truly appreciate any help and insight you can provide. Thanks!

Motiv Girl
10-12-2009, 12:34 PM
This is an indication that too little reverse is in the thumb or a span that is too long.It can also be
a sign that she is picking the ball up out of the swing at the bottom,or in other words,she is hitting up
on the ball at the point of release.This is not normal and should not be happening,have the pro should
check again or go to another pro shop.The normal wear spots is on the outside of the thumb at the
knuckle ,and some wear in the web.

bowl1820
10-12-2009, 02:04 PM
Take a look here on the Jayhawk page. It shows pictures of what the different wear spots indicate.

Click here Fitting_Tips (http://www.jayhawkbowling.com/Pro_s_Corner/Fitting_Tips/fitting.html)

Example-
http://www.jayhawkbowling.com/Pro_s_Corner/Fitting_Tips/fig9.jpg

* A - Span Too Short
* A - Excessive Reverse Pitch
* B - Excessive Left Pitch
* B - Hole Too Small

And Motiv Girl if your getting wear spots on thumb knuckle or web I'd have those checked. You shouldn't have a wear spot anywhere.

Iceman
10-12-2009, 02:58 PM
Wear spots are too familiar for me. I've had them all :) - I went to different pro shop last year, and of course, even after they watched me bowl - he shortened my span, took the reverse pitch out and told me to stick with it a few months even after I went back and showed him the spots on my thumb and at the base. Shorter spans are the new thing now. I since went back to my old driller, he was at USBC nationals last year when I was ready to buy - ;) so I learned a lesson and I have zero wear on my fingers or thumbs (since working out the thumb pitch 1/8 reverse and 1/8 left. I do have a slight raised thumb nuckle from my younger years of ripping the coverstock off, but I just wear the thumb tape and it's decreased dramatically - which causes me to reach in and add tape (which I don't mind). I can make it smaller while at the house, just not bigger easily

poflobo
10-12-2009, 03:45 PM
Wear spots are too familiar for me. I've had them all :) - I went to different pro shop last year, and of course, even after they watched me bowl - he shortened my span, took the reverse pitch out and told me to stick with it a few months even after I went back and showed him the spots on my thumb and at the base. Shorter spans are the new thing now.

I've read in several different posts about "short spans". I don't get it... Takes away your leverage and makes it tougher to get a decent grip on the ball. Can you educate me a little?:confused:

Motiv Girl
10-12-2009, 04:08 PM
I did not say burn or blusters on thumb knuckle,just normal callusing or hardening from continuous
reps.Now if you think I'm talking about burn marks,I am not.That is totally different from from small
hardening on outside of thumb.This is from Jayhawk also.

Normal Callus:
{An average bowler will form a callus - a hard, thickened area on the skin - wherever the fingers and thumb have contact with the ball. It is formed because of the weight bearing of the ball on certain parts of the hand. This may be good for a bowler.)

Pathological Callus:
Excess pressure, an ill-fitting ball, and improper use of a properly fitted ball may cause what is known as a pathological callus. This is one to worry about because it is painful and greatly hinders a bowler. The pathological callus is a hard mass of skin surrounded by an inflamed rim and it may have a deep central core like a corn. These areas do not stretch when the thumb or finger are flexed. The result is a burning sensation.

I do not have any problems with my fit,never have and never will.May driller is a family member.

bowling mom
10-13-2009, 07:21 PM
This is really helpful, but I'm still confused... Please keep discussing!

Neither A nor B in the picture shown in this thread is where the burn mark is. In that picture, the mark is located on the upper side of the thumb, a little bit on the far side where we can't see it.

Is it the pitch? Is it the span? Is it the thumb hole being too snug?

bowl1820
10-13-2009, 10:07 PM
This is really helpful, but I'm still confused... Please keep discussing!

Neither A nor B in the picture shown in this thread is where the burn mark is. In that picture, the mark is located on the upper side of the thumb, a little bit on the far side where we can't see it.

Is it the pitch? Is it the span? Is it the thumb hole being too snug?


Click this link to see the other examples of fitting problems (http://www.jayhawkbowling.com/Pro_s_Corner/Fitting_Tips/fitting.html)

to find the one that matches or is closest to what you see on the thumb.

bowling mom
10-14-2009, 07:02 PM
You see, this injury isn't one of the ones listed there. That's why I'm so confused! Should we fix the span or the pitch or the hole size? What *is* this injury anyway? It has to be somewhat common enough for other people to have had it.

JaxBowlingGuy
10-14-2009, 07:44 PM
a picture may be useful

bowl1820
10-14-2009, 07:50 PM
You see, this injury isn't one of the ones listed there. That's why I'm so confused! Should we fix the span or the pitch or the hole size? What *is* this injury anyway? It has to be somewhat common enough for other people to have had it.

Well if none of the examples on the Jayhawk fitting page are even close, you could post a photo of the thumb.

Then we could give a opinion on it, But the best answer is that you need to go to the Pro-shop and have the pro look at it.

That would be your best bet in fixing a fit problem. Then you can work directly with the driller in making the proper adjustments to the grip. That's what he's there for and making a change to the fit is no big deal.

fairgq1
10-24-2009, 09:07 PM
motiv girl and bowling mom,

you both need to get into the pro shop and have your spans and pitches checked, there is
absolutely no reason for any wear marks or burn marks on your thumb.
I bowl 20-25 games a week and I have none of those on my thumb.
make sure you thumb hole is the correct size, a lot of times you need some oval to make it right
and if the driller only drills it round it wont fit right.



Allen

Bowlflorida
10-25-2009, 11:22 AM
If the " burn" mark is a dark brown and looks like a blood blister below the skin the main cause of this is squeezing at the bottom of the release this will cause the HIT UP effect that Motiv was speaking of...make sure her hand is soft ( not grabbing the ball ) at the release point ...should solve the problem if not go see another pro shop and have them change the pitches until she is not getting the "burn" mark....

Strike Domination
10-25-2009, 11:19 PM
If the " burn" mark is a dark brown and looks like a blood blister below the skin the main cause of this is squeezing at the bottom of the release this will cause the HIT UP effect that Motiv was speaking of...make sure her hand is soft ( not grabbing the ball ) at the release point ...should solve the problem if not go see another pro shop and have them change the pitches until she is not getting the "burn" mark....

Funny that you mention this. I squeeze from the get-go generally, and I don't know about looking like a blood blister, but I have this burn-type mark on my thumb. I'm trying to learn to keep my thumb straight(an off and on process for the past year now) and it seems to be going away. When I try to keep my thumb straight(and most times when I squeeze), I do exactly what you just said about grabbing the ball at the bottom and getting a "hit up" effect. Sometimes it's only a little which seems to still give a good roll, but sometimes I do it a bunch and it's just as bad as squeezing all the way if not worse.

When I manage to keep the thumb straight all the way through, it looks to me like I get more tilt but only like 3 revs. I don't know what's wrong but that's not going to work. Something is wrong with my fit I'm sure. I talked to a guy in my league who happens to work in the shop and he would increase the ring finger span to 4 1/4(Middle 4 1/4, Ring 4 1/8 now). I have 1/8 forward and 1/4 left thumb pitches(I'm right handed) and still have irritation/soreness on the right side of my thumb at sometimes(probably from the squeezing, not really there when I keep the thumb straight). I have this weird thing with my thumb where it wants to "lean" toward the fingers(the same side my soreness occurs) kinda like it's slipping, so something to do with that might be why I have troubles keeping the thumb straight. White tape in both front and back help and I think I can do it if I make it tight enough but it's so hard to get the release to work properly.

fairgq1
10-25-2009, 11:44 PM
strike domination, Why do you have 1/8 forward in your thumb?
a trick I use to make sure my thumb comes out straight and I do not squeeze is
I put my fingers in and then stretch my hand towards the thumb hole and hold my thumb straight and slide it in right
down the front of the thumb hole, this ensures a clean and tight grip but comfortable.

Strike Domination
10-26-2009, 12:24 AM
The 1/8 forward is due to my span if I'm not mistaken. Adding some reverse has definitely crossed my mind but I don't want to end up not being able to hold onto the ball. I will say that I've been told the joint in my thumb is pretty stiff if that means anything to you(I think that indicates that I need left pitch).

The thumb leaning that I mentioned sort of keeps my thumb from staying straight naturally. When it shifts, my thumb bends just a little, and keeping the thumb straight is something I have to put effort into. Getting the thumb hole tight enough so that my thumb is almost shoved in will make it so that it barely moves but I ight need some reverse to clear the thumb properly. And like I said I just can't seem to get the release to function how I want it to either way.

Motiv Girl
10-26-2009, 11:51 AM
Making changes such as adding wrist devices or other types of gloves can have a great affect on how your hand fits into the bowling ball.
Also making adjustments to your physical game can have a great affect on how your hand holds onto
or releases the bowling ball.It is your responsibility to make sure your ball driller is aware of the
changes you are trying to make in your game.

Thumb:
1.Callus on back of the thumb.This is a great indicator that you are knuckling the ball and holding the ball
more with the thumb than you are with the fingers.You either have too much reverse in the thumb,
causing you to squeeze it with the thumb,or it could be that you are out of rhythm.It can also mean
your span is too long.
2.Burn mark on tip of the nail of the thumb which may turn black after a while.This means you have too
little reverse or a span that is too long.It is also a sign you are hitting up on the ball at the release point.
3.Calluses on both sides of the thumb.This is usually not a grip problem but more of a sign that you are
turning the ball early at the bottom of the swing and probably turning the ball more with the thumb
than you are with the fingers.
4.If you have callus buildup on the inside part of the thumb,it only means that you are coming over
the top of the ball,which is usually caused by wrapping the ball behind your back during the swing.
5.A burn mark on the front side of the tip of the thumb,that often turns brown.This is a sign that you
have too little reverse in the thumb,too long of a span,or are having your swing wrap around behind
your back.It can also mean that you are trying to grab the ball at the point of release in an effort to
try to put more revolutions on the ball than your physical game is set up to deliver.This is common
with bowlers who wear wrist devices.
6.Callus on the front side of the thumb at the base and another on the outside edge of the thumb.Now this is just slight wear from constant repetitions of the ball coming of the thumb,and not any large
callus, or blister, or burn mark, or black mark.That is all it is nothing more!Okay.

Fingers:
1.Calluses on both sides of the fingers.This is usually a sign of a couple of different things,one being that
the finger holes are way too tight.When this happens it causes the skin to spread out and touch the side
walls of the holes causing the skin to be irritated.At first there are blisters,soon followed by callus buildup.
The second thing that usually causes these calluses to appear is when a bowler comes over the top
(over-turning) at the point of release.
2.Callus buildup on the inside part of the fingers.This is a very common sign that a bowler is turning
the hand too early and then trying to correct it at the point of release by trying to turn the hand
back behind the ball as the release is completed.
3.Callus buildup on the outside part of the fingers.This is a rare on to see and usually not a flaw in the physical game but a flaw in the grip having too little side pitch.
4.Burn mark on the nails of the fingertips.This is very common sign when the grip is too long or the pitches are tucked too far under and don't accommodate the flexibility or lack of flexibility of this
part of the hand.
5.Moving to the front side of the pads of the fingers.Callus buildup is at the tips of the fingers and not
centered on the pads of the fingers.This is without a doubt a span is way too long.It's something
you see a lot with bowlers that are trying to get more revs on the ball.Of course, it doesn't work
out that way and just causes these bowlers to hit up on the ball at the point of release and to
get out of the ball late.
6.If the callus is in the center of the finger tip pad.There is nothing wrong with this type of callus
as long as it isn't overly thick.(Just normal wear).
If the center of the pad callus turns into a burn mark or brown mark.it is mostly caused by hitting up on
the ball at the point of release or having the fingers pitched too far under,causing them to drag
as they exit the finger holes.

Whatever you do,don't just leave it up to the ball driller to keep track of where your grip started and the changes that you have made along the way.Request a copy of each of your drill sheets and keep them in order by dating them so that you know what changes were made and when.
The hand is a complex part of the body and many times it just takes small adjustments with the fit
to be able to have a comfortable feel,so be sure to discuss them with your ball driller to help solve
some of the problems.

Also I don't know where anyone gets from my earlier remarks ,that I have calluses or any hand
problems.
I have 0 (ZERO) problems with my fingers or thumb.My ball driller has drilled my bowling balls for years
and I have never had issues.
Thanks, and good luck and good bowling everyone.

bowl1820
10-26-2009, 02:43 PM
Also I don't know where anyone gets from my earlier remarks ,that I have calluses or any hand
problems.
I have 0 (ZERO) problems with my fingers or thumb.My ball driller has drilled my bowling balls for years
and I have never had issues.
Thanks, and good luck and good bowling everyone.

I believe it came from your first post in this thread, where you said


This is an indication that too little reverse is in the thumb or a span that is too long.It can also be
a sign that she is picking the ball up out of the swing at the bottom,or in other words,she is hitting up
on the ball at the point of release.This is not normal and should not be happening,have the pro should
check again or go to another pro shop.The normal wear spots is on the outside of the thumb at the
knuckle ,and some wear in the web.

then I said


And Motiv Girl if your getting wear spots on thumb knuckle or web I'd have those checked. You shouldn't have a wear spot anywhere.

I'll stand by that. A wear spot is not normal, if it was a normal thing "where are yours? " you said it yourself above. You have a good fit and are not getting any wear areas (Zero).

Motiv Girl
10-26-2009, 03:39 PM
Normal other than excessive callusing.I did not say that I have any.Other people may have some
but I do not.Also most of my post came from a article and what I was told in person during lessons by one of the best ball drillers and coaches in the world.Bill Hall.
Again, also from Jayhawk!
Fitting Tips

Getting just the right fit is the most important aspect of running a pro shop. If a ball doesn’t feel right, the bowler won’t relax his hand in the ball and won’t be able to roll it properly.

Diagnosing problems with balls that a customer brings to you is an important aspect of making a customer feel confident in your ability to drill his new equipment and possibly gain you a new customer for life!! Here are some tips for checking a bowler’s hand and calluses:

The Importance of Checking the Bowler’s Hand:
Any bowler who bowls too little, or too much, is bound to have problems with his or her bowling hand. The infrequent bowler does not give the hand a chance to become accustomed to the friction caused by the ball leaving the hand.

No matter how good the fit, there must be some degree of pressure on the fingers and thumb. If the bowler does not bowl often enough, blisters may form at the spots of contact. These usually are minor and develop when the occasional bowler bowls too many games in one session.

(Normal Callus:)****
An average bowler will form a callus - a hard, thickened area on the skin - wherever the fingers and thumb have contact with the ball. It is formed because of the weight bearing of the ball on certain parts of the hand. This may be good for a bowler.

Pathological Callus:
Excess pressure, an ill-fitting ball, and improper use of a properly fitted ball may cause what is known as a pathological callus. This is one to worry about because it is painful and greatly hinders a bowler. The pathological callus is a hard mass of skin surrounded by an inflamed rim and it may have a deep central core like a corn. These areas do not stretch when the thumb or finger are flexed. The result is a burning sensation.

Motiv Girl
01-18-2010, 01:33 PM
Another look bowlers thumb.If you don't think an improper fitted ball,or bad technique
can have that much affect on your hand ,then please read this article.HEY GUYS I'm sorry that the link
needed you to register first.I'm sure most of you would not want to do that,so I just posted the article.
I hope this is okay with some!!


Two Different Types of Bowler's Thumb
By Keiichi Muramatsu, MD; Koji Yoshida, MD; Toshihiko Taguchi, MD
ORTHOPEDICS 2009; 32:525
Abstract

Two rare cases of bowler's thumb (traumatic neuropathy of the ulnar digital nerve of the thumb) were treated surgically with encouraging results. These had different types of lesion, involving nodular neuroma and epineural mass, which were distinguished by magnetic resonance imaging. The surgical outcome for active bowlers is unclear and postoperative protection from the repetitive trauma of throwing is important. Possible technical solutions include changing the size and weight of the ball, the spacing between holes, the fitting of thumb to ball, and the slope and size of thumb holes. It is important that both bowlers and clinicians are sufficiently aware of bowler’s thumb to allow early diagnosis and treatment of this lesion.

Bowling is a popular sport internationally and especially in eastern Asia and North America. It is associated with the development of physical problems in many regions of the body, but a common problem occurs in the hand. The term “bowler’s thumb” was first reported by Siegel in 1965,1 which is traumatic digital neuropathy of the palmer digital nerve supplying the medial aspect of the thumb. This lesion is often referred to in text books. To our knowledge, however, only a small number of articles on this subject have been published in the English literature. This may be related to the different frequencies with which bowling is played in various countries.

This article presents 2 different types of bowler’s thumb. Each type was treated surgically with encouraging results.
Case Report

Patient 1

A 31-year-old male amateur bowler presented with a small and painful mass in the right thumb of 3 months’ duration. The patient noticed increasing pain and numbness over the most recent 3 weeks. He began bowling 2 years earlier and participated 3 times per week. Recently, he changed the thumb hole to a more distal location (longer span) to gain more speed with the ball.

Physical examination revealed a firm, tender nodule on the ulnar side of the thumb at the level of the metacarpal phalangeal joint. Range of movement of the thumb was normal. Tinel’s sign on the nodule was positive. The Semmes-Weinstein monofilament test showed severe sensory disturbance (4.31) on the ulnar side but a normal value (3.22) on the radial side. Gadolinium-enhanced MRI revealed a 5-mm diameter nodule at the ulnar digital nerve (Figure 1A). There was no mass around the nerve. The symptoms had recurred after interruption of bowling for 2 months.

Microsurgical neurolysis of the affected nerve was performed under local anesthesia and an enlarged neuroma surrounded by fibrous connective tissue was found (Figure 1B). The affected nerve was decompressed by stripping the thickened epineurium. Postoperative relief of symptoms was good and the patient returned to bowling 3 months after neurolysis and has been asymptomatic for 1 year. Sensory disturbance measured with the Semmes-Weinstein test improved to 3.22. The location of thumb hole was moved closer to the finger holes.
Figure 1A: Gadolinium-enhanced MRI revealed a nodule at the ulnar digital nerve Figure 1B: An enlarged neuroma surrounded by fibrous connective tissue was found intraoperativly

Figure 1: Gadolinium-enhanced MRI revealed a nodule at the ulnar digital nerve (A). An enlarged neuroma surrounded by fibrous connective tissue was found intraoperativly (B).

Patient 2

A 19-year-old female semi-professional bowler presented with a painful soft mass along the flexor tendon of the right thumb. She had noticed the mass 1 year earlier. Recently, the pain had become worse following increased levels of bowling practice in preparation for an amateur bowling tournament.

Physical examination showed a 1.5-cm tender soft mass along the flexor tendon at the base of the right thumb. The thumb had full range of motion and Tinel’s sign was positive. Sensory disturbance was mild (3.86) with the Semmes-Weinstein test. Magnetic resonance imaging revealed a round mass at the base of the affected thumb that showed low-intensity signal on T1-weighted image, high intensity signal on T2 and was found to compress the ulnar digital nerve (Figure 2A).

Microsurgical neurolysis and resection of the mass was performed under general anesthesia. The mass was located over the central portion of the proximal phalanx and was freely movable. The ulnar digital nerve adhered tightly to the mass but could be separated under careful microsurgical dissection (Figure 2B). The pathology of the mass was reactive, inflammatory granulation tissue. The patient resumed bowling 3 months postoperatively. She changed the location and size of the thumb hole. After 6 months she reported slight discomfort in the area of the scar and was almost symptom free at 1 year.
Figure 2A: A round mass at the base of the affected thumb Figure 2B: The ulnar digital nerve adhered tightly to the mass

Figure 2: MRI revealed a round mass at the base of the affected thumb was found to compress the ulnar digital nerve (A). The ulnar digital nerve adhered tightly to the mass but could be separated under careful microsurgical dissection (B).
Discussion

Bowler’s thumb is the development of traumatic neuropathy characterized by proliferation of the fibrous tissues around and within the digital nerve. Perineural fibrosis can arise due to repetitive, minor trauma. As scarring in this area increases, the nerve becomes more fixed and therefore less likely to be displaced sufficiently to escape irritating pressure. The hard edge of the bowling ball hole impacts precisely at the base of the thumb where lesions arise. The ulnar digital nerve on the web side of the thumb is particularly vulnerable during bowling because it lies superficial to the sesamoid bone and within a thin layer of subcutaneous tissue.

Most of the English literature describing bowler’s thumb was published in the 1970’s.2-5 The largest study was reported by Dobyns et al2 in 1972 who reviewed 17 bowling enthusiasts with reports concerning the web side of the thumb. Of these cases, 8 were relieved conservatively and 7 underwent surgery. Interestingly, 2 patients underwent surgery because of doubts regarding the correct diagnosis. One of these patients had a history of nodules and a typical neuroma was found. The surgical procedure for this patient involved careful neurolysis of extraneural and epineural scars. The other patient suffered not only from hand neural fibrosis within and around the digital nerve but also from proliferative synovitis, which appeared to arise from the sheath of the flexor pollicis longus tendon. Excision of this mass and careful neurolysis was performed and resulted in pain relief.

From the previous literature and our experience, there appears to be 2 types of bowler’s thumb. In our patients, patient 1 with nodular neuroma was similar to the first case in the Dobyns series,2 while patient 2 with a mass around the nerve was similar to the second case in the Dobyns series.2 Minkow and Bassett3 described 3 cases and Dunham et al4 reported 2 cases with the nodular type, while Howell and Leach5 described 1 case with the mass type. These 2 types were clearly distinguished by MRI in the present study. The mass type was detected as a low-intensity lesion in T1-weighted image and high-intensity lesion in T2-weighted image because its pathology was inflammatory granulation.

A different type of classical bowler’s thumb, “acute bowler’s thumb”, was reported by Ostrovskiy and Wilbourn6 in 2004. They described 2 cases that developed pain and paresthesia of the thumb from a single occurrence of compression by throwing. In these cases the patients did not appear to have a nodule or mass at the base of the thumb. This type should be classified as the third type.

The treatment of bowler’s thumb remains controversial. It is not yet clear how many patients require surgery, but the percentage is likely to be low. The outcome from surgery may be good when the digital nerve is severely compressed by a perineural mass. However, surgery is unlikely to completely restore the thumb to normal. Desmet et al7 recently reported a new operative technique involving transposition of the nerve beneath the adductor pollicis, which must be incised and repaired.7 The surgical outcome for active bowlers remains unclear and postoperative protection from the repetitive trauma of throwing is therefore important. Possible technical solutions include changing the size and weight of the ball, the spacing between holes, the fitting of thumb to ball, and the slope and size of thumb holes. It is important that both bowlers and clinicians are sufficiently aware of bowler’s thumb to allow early diagnosis and treatment of this lesion.

WAC4504
01-20-2010, 06:15 PM
I have never had callus' on my thumb or finger tips, so I would have to agree with the Iceman. I truly believe that it has a lot to do with how a ball is drilled for the individual, and how the individual throws the ball. I would check with the ball driller first and if that didn't work, have it checked at another shop. Good luck and good bowling. Bill